Percutaneous coronary intervention (PCI) is the most widely employed coronary revascularization procedure worldwide (Chap. 276). It is now applied to patients with stable angina; to patients with acute coronary syndromes, including unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI); and as a primary treatment strategy in patients with ST-segment elevation myocardial infarction (STEMI). PCI is also applicable to patients with either single-vessel or multivessel disease.
In this chapter, the use of PCI will be illustrated in a variety of commonly encountered clinical and anatomic situations, such as chronic total occlusion (CTO) of a coronary artery, bifurcation disease, calcified coronary stenoses, acute STEMI, saphenous vein graft disease, left main coronary artery disease, multivessel disease, and stent thrombosis. Management of coronary perforation will also be addressed. In addition, the use of interventional techniques to treat structural heart disease will be shown, including transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, closure of a paravalvular leak, closure of an atrial septal defect (ASD), left atrial appendage closure, and alcohol septal ablation.